Individual provider Active NPI

Chenoa Yolanda Shenandoah, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1154761542
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
17737 Issued in TN
Practice address
318 N Forest Park Blvd
Knoxville, TN 37919-5127
Phone
(865) 263-2200
Fax
(865) 263-2300
NPI assigned
Jun 28, 2013
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 17737 TN Primary

Addresses

Primary practice location

318 N Forest Park Blvd
Knoxville, TN 37919-5127

Mailing address

318 N Forest Park Blvd
Knoxville, TN 37919-5127
Phone (865) 263-2200

Other identifiers 2

IdentifierTypeStateIssuer
149380OtherTNTN RN LICENSE
17737OtherTNTN APN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130923000216 TN Practitioner - Nurse Practitioner 9133363740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Dynamics Behavioral Health LLCGroup PAC ID 5294199857, 2 clinicians

Practice addresses (Care Compare)

318 N Forest Park Blvd
Knoxville, TN 37919-5127
Phone (865) 263-2200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17737TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dynamics Behavioral Health LLC CurrentSince Aug 10, 2023 Accepting new patients
Tennessee Valley TMS, LLC CurrentSince Aug 2, 2020 Accepting new patients

Locations

194 Market Place Blvd
Ste B
Knoxville, TN 37922
Phone (865) 212-6600

318 N Forest Park Blvd
Knoxville, TN 37919
Phone (865) 263-2200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1154761542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 N FOREST PARK BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195127",
            "telephone_number": "865-263-2200",
            "fax_number": "865-263-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N FOREST PARK BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195127",
            "telephone_number": "865-263-2200",
            "fax_number": "865-263-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENANDOAH",
        "first_name": "CHENOA",
        "middle_name": "YOLANDA",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "17737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN RN LICENSE",
            "identifier": "149380",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN APN LICENSE",
            "identifier": "17737",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.